A case of rectal cancer with multiple pulmonary and liver metastases could be resected through chemotherapy

The patient was a 47-year-old man, whose chief complaint was melena. He visited a nearby hospital, and further evaluation showed rectal cancer invading the prostate, with multiple lung and liver metastases. The clinical diagnosis was cT4b (prostate), cN1, cM1b (H2, PUL2), cStage IV. We performed colostomy in the transverse colon prior to chemotherapy. He was administered 1 course of mFOLFOX6 plus bevacizumab and 7 courses of FOLFOXIRI plus bevacizumab. The primary tumor showed PR. The liver metastases were localized and shrunken, while the lung metastases disappeared. Approximately 6 months after the start of chemotherapy, a laparoscopic total pelvic exenteration and ileal conduit were performed following the diagnosis of ycT4b (prostate), ycN1, ycM1a (H2), ycStage IV. About 3 months later, a partial resection of the left liver lobes (S1 and S5/S8) was performed laparoscopically. He has been cancer-free for 8 months.